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Agios Pharmaceuticals, Inc. (AGIO)

Q2 2024 Earnings Call· Thu, Aug 1, 2024

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Transcript

Operator

Operator

Good morning, and welcome to Agios' Second Quarter 2024 Conference Call. [Operator Instructions]. Please be advised that today's call is being recorded at Agios' request. I would now like to turn the call over to Chris Taylor, Vice President, Investor Relations and Corporate Communications for Agios.

Chris Taylor

Analyst

Thank you, operator. Good morning, everyone, and welcome to Agios' conference call and webcast to discuss second quarter 2024 financial results and recent business highlights. You can access slides for today's call by going to the Investors section of our website, agios.com. On today's call, I’m joined by our Chief Executive Officer, Brian Goff; Dr. Sarah Gheuens, Chief Medical Officer and Head of Research and Development; Tsveta Milanova, our Chief Commercial Officer; and Cecilia Jones, Chief Financial Officer. Before we get started, I would like to remind everyone that, some of the statements we make on this call will include forward-looking statements. Actual results and events could differ materially from those expressed or implied by any forward-looking statements as a result of various risks, uncertainties and other factors, including those set forth in our most recent filings with the SEC and any other future filings that we may make with the SEC. With that, I'm pleased to turn the call over to Brian.

Brian Goff

Analyst

Thanks Chris. Good morning, everyone, and thank you for joining us. Our mission at Agios is to develop and deliver transformative medicines that elevate and extend the lives of patients living with rare diseases. Our foundation leverages mitapivat's novel mechanism of action, which improves overall red blood cell health and has been a key driver of our positive clinical data readouts in recent years. I'm delighted to report that, we continued our positive momentum in Q2 with multiple key milestones announced this quarter. First, we announced that the Phase 3 ENERGIZE-T study of mitapivat met both the primary endpoint and all key secondary endpoints in adults, with transfusion-dependent alpha or beta-thalassemia. Importantly, ENERGIZE-T is the first Phase 3 study to demonstrate efficacy of an oral disease-modifying treatment for transfusion-dependent alpha and beta-thalassemia. Second, data from the positive Phase 3 ENERGIZE study of mitapivat in adults with alpha or beta thalassemia, who are not regularly transfused, were presented by leading KOLs in two presentations at the recent European Hematology Association Congress in Madrid, including a plenary session. Taken together with the positive data from ENERGIZE-T, we plan to submit an sNDA for mitapivat in thalassemia, based on all available data from both ENERGIZE and ENERGIZE-T by the end of 2024 seeking a label that covers people living with all subtypes of thalassemia. Third, we announced that Agios has agreed to sell its rights to a 15% royalty on potential U.S. net sales of Servier's Vorasidenib to Royalty Pharma. Under the terms of the agreement, Agios will receive an upfront payment of $905 million upon approval of vorasidenib by the FDA. Cecilia will revisit the details in a moment and I would like to thank her for directing the process and structuring a tremendous agreement for Agios, our shareholders and a win-win…

Sarah Gheuens

Analyst

Thanks, Brian. This morning, we were very pleased to announce top-line data from the Phase 3 ACTIVATE-kids T study of mitapivat in children with CK deficiency who are regularly transfused, which is the first Phase 3 study to report data in this population. Importantly, the first completed pediatric study of mitapivat for Agios. We are also pleased to report that, we have completed enrollment in the complementary ACTIVATE-kids study of mitapivat in children with PK deficiency who are not regularly transfused. Next year, we aim to report top-line data from the second study and we'll review all available data from both the ACTIVATE-kids T and ACTIVATE-kids studies. Turning now to the data from ACTIVATE-kids T reported to date. As this first slide depicts, our pediatric PK deficiency program includes two Phase 3 studies evaluating regularly transfused and not regularly transfused pediatric patients with Pyruvate Kinase deficiency in ACTIVATE-kids T and ACTIVATE-kids, respectively. Children represent approximately 20% of the total patient population in PK deficiency and there are no therapies approved for pediatric PK deficiency. Turning to the top-line results announced this morning for the ACTIVATE-kids T trial. A total of 49 patients were enrolled in the study with patients randomized two to one to either mitapivat five daily or placebo. The study consists of a 32-week double-blind period followed by an open label extension period. 30 of the 32 patients in the mitapivat arm and 16 of the 17 in the placebo arm completed the double-blind period of the study. As we noted in our news release this morning, using Bayesian methodology, the pre-specified statistical criterion for the primary endpoint in ACTIVATE-kids-T was not met using low or moderate borrowing of data from the ACTIVATE-kids study in results. The results were clinically meaningful as transfusion reduction response and normal hemoglobin…

Tsveta Milanova

Analyst

Thanks, Sarah. Today, a diagnosis of thalassemia can be daunting for patients and their families. Having just returned from the Cooley's Anemia Foundation Patient and Family Conference in Atlanta, we heard many powerful stories emphasizing the debilitating impact thalassemia may have on patients and their families. All forms of thalassemia bring higher rates of serious morbidities, reduced quality of life and a heightened risk of premature death. It is challenging for patients to navigate the disease because treatment options are limited and the burden of disease as well as the associated cost of care is significant. Based on the positive data we have generated in the ENERGIZE and ENERGIZE-T studies, we aim to transform the treatment of this disease and bring to market the first therapy approved for all thalassemia subtypes. There are approximately 6,000 adults diagnosed with thalassemia in the U.S., approximately 4,000 of whom are non-transfusion dependent. In the U.S. There are no oral therapies approved for patients living with thalassemia and for those with non-transfusion dependent disease, there are no approved therapies at all. Our commercial organization is actively preparing to address this high unmet need with a potential U.S. launch of PYRUKYND in thalassemia next year. In addition to the consistent and compelling data we have generated in the mitapivat development program, we believe there are three key factors that have the potential to support adoption of cytokines in thalassemia in the U.S. First, driven by the availability of newborn screening and well-established ICD-10 code, the diagnosis rate in thalassemia is high with many patients diagnosed before adulthood. Second, both patients and providers are concentrated in a limited number of centers with approximately 50% of all diagnosed patients treated at a fewer than 150 affiliated practices, providing a clear focus for our initial launch. And third,…

Cecilia Jones

Analyst

Thanks, Tsveta. Our second quarter 2024 financial results can be found in the press release we issued this morning and more detail will be included in our 10-Q, which will be filed later today. Let me now take a moment to provide some context and highlight a few key points. Second quarter 2024 net PYRUKYND revenue was $8.6 million an increase of $1.9 million compared to the second quarter of 2023. Consistent with other rare disease launches, gross to net has been and is expected to be in the 10% to 20% range on an annual basis. As we favor our organization's focus to the thalassemia launch preparedness, we expect to see more muted growth going forward and quarter-over-quarter variability in PKD revenues. Cost of sales for the quarter was $1.5 million. R&D expenses were $77.4 million for the second quarter, an increase of $8.5 million compared to the second quarter of 2023. The year-over-year increase was primarily attributable to an increase in cost associated with the TMPRSS6 program in license from siRNA last year. SG&A expenses were $35.5 million for the second quarter, an increase of $5.1 million compared to the same quarter in 2023. This was primarily attributable to an increase in commercial-related activities, as we prepare for the potential approval of PYRUKYND and thalassemia. As a reminder, this quarter we announced that the company has agreed to sell the rights to its 15% royalty on potential U.S. net sales of Servier vorasidenib to Royalty Pharma. Under the terms of the agreement, Agios will receive an upfront payment of $905 million upon approval of vorasidenib by the FDA and Royalty Pharma will receive the entirety of the 15% royalty on annual U.S. net sales of vorasidenib up to $1 billion and 12% royalty on annual U.S. net sales…

Brian Goff

Analyst

Thanks, Cecilia. Driven by a novel and differentiated mechanism of action that improves red blood cell health, mitapivat has continued to deliver positive late-stage data readouts spanning three hemolytic anemias and we're pleased to have now completed our first Phase 3 trial in a pediatric patient population. Based on this consistent and compelling data package and the demonstrated strength of the Agios team, we continue to believe that, mitapivat is poised to become a first-in-class and best-in-class treatment option for multiple indications and to become a multibillion-dollar franchise. Our focus is squarely on thalassemia, where we aim to file an sNDA by the end of this year and seek a label that covers people living with all sub-types of the disease. As we continue to take steps towards realizing our vision of becoming a leading rare disease company, we'll continue to strive to be responsible stewards of our balance sheet and evaluate meaningful opportunities for value creation. Finally, I'd like to thank all of our employees for their hard work and dedication to our mission of developing and delivering transformative medicines that elevate and extend the lives of patients living with rare diseases and all of our partners including the patients, physicians, caregivers and participants in our clinical development programs. With that, we'll now open the call for questions.

Operator

Operator

[Operator Instructions]. Our first question comes from Eric Schmidt from Cantor Fitzgerald. Your line is now open.

Eric Schmidt

Analyst

Thanks for taking my question and congrats on all the continued progress. Maybe I'll ask about the new development today, the NewBridge transaction. Can you give us a little bit more color on some of the economics there and what you hope to receive and maybe also talk about, the timing now that you have breakthrough designation in Saudi Arabia? Thanks.

Brian Goff

Analyst

Thanks, Eric. Tsveta worked really hard with quite a large team on this new arrangement with NewBridge and GCC. You know that, that's our second most important market for thalassemia and the first most important outside the U.S. So, I'm going to let Tsveta comment on that.

Tsveta Milanova

Analyst

That's wonderful and we are really, really happy to announce the agreement with NewBridge because we've been working hard to select a partner with a very thorough and good experience in the region to represent us as Agios. We are also very proud to announce that we actually received the breakthrough medicines designation from the Saudi FDA with Saudi Arabia being the biggest market in the region and we look forward to work with NewBridge actually to utilize the breakthrough designation and submit for regulatory approval for thalassemia as soon as possible. We'll be providing more information on that, as we enter into the process. When you think about the new operations agreement that we have with them, they are full service distributor. They will represent Agios across the board from regulatory approval and commercialization activities across the whole region. It's a very typical kind of agreement for this type of relationships, which is basically a revenue split deal. There'll be no upfront payments for us as Agios. As we continue to basically progress this commercialization, there'll be a revenue split as part of it. When we look at the region, we are really, really excited about the potential of our product, because not only that there is a high unmet medical need in the region, but we have conducted clinical studies in the region. There is already a firsthand experience with some of the key centers and care wealthy in the region and we look forward to provide access to patients. And then, Eric, to follow-up on the question around timing of regulatory engagement, we are of course very excited to keep on moving forward with the development of our program. And so, in part, we will be working as soon as we can with the regulators across the board.

Brian Goff

Analyst

I'll just close by saying that breakthrough medicines designation in Saudi is pretty unusual. And so, we've been pleased to have that as a recognition of, as Sarah noted, just a profound unmet need in that region. It's an important part of the puzzle for us. as we get ready to expand our presence outside the U.S. and particularly focus on these high unmet need regions.

Operator

Operator

Our next question comes from Christopher Raymond from Piper Sandler. Your line is now open.

Christopher Raymond

Analyst

Thanks. Just a couple from me. Just with, vorasidenib's upcoming PDUFA, you guys, as you noted in your press release, you're in line for pretty meaningful cash infusion. Brian, I know you've talked about M&A and I'd say, your language has been relatively cautious, I guess, in the past. But this is a $1 billion-plus infusion sort of changes things, I would guess, in terms of the size and scope of what you could do. Can you maybe talk about how you're viewing M&A now as a lever after the August 20 PDUFA? And then, I have a follow-up question.

Brian Goff

Analyst

Yes, sure. Thanks a lot. Obviously, I just want to reiterate again. I'm very proud of the work that Cecilia did with the royalty monetization of vorasidenib, that's an important step. As a side note, vorasidenib itself is a mark of excellence for Agios science. It's very important for patients and of course it adds to our potential balance sheet enhancement. So, I think, you mentioned M&A, I'll just maybe take it up a step and just talk about capital allocation for us. The focus is efficient use of capital no matter what. This certainly puts us in a position of strength. Our top priority above all else is preparing for and delivering upon these really important launches that we have near-term. We're quite excited about the fact that, with success, this could be back-to-back launches. Thalassemia, Tsveta and the team are preparing for next year. As we noted in our comments with sickle cell disease, the RISE UP trial is on track for complete enrollment by year end that points towards data readout next year and then again, the possibility for a back-to-back launch. That's the number one priority. Secondly, we continue to make great progress on advancing our own internal pipeline and of course that will use some of the capital. A great example is MBS and we're looking forward to commencing on the Phase 2b study for low risk MBS. That's a market that is growing beautifully and we're very excited about that potential. And that's by the way with tebapivat, which we were pleased to announce today as our INN for what was formerly known as AG-946. And then to your point, Chris, about business development more broadly, it's always a focus. That said, we're very disciplined because we have no shortage of internal organic opportunities as well. Cecilia and the team do a great job of making sure that our analysis of what creates the most value-enhancing opportunity goes through a rigorous and very competitive process. And BD, all of that is certainly in our sites, but again, great organic opportunities as well.

Christopher Raymond

Analyst

Okay, great. And then, maybe just a quick follow-up. On sickle cell and the opportunity, we've had some feedback from KOLs that not all sickle cell patients experience VOCs. Maybe just talk about your view around VOCs as an endpoint and the applicability for a broad population?

Brian Goff

Analyst

Yes, that's a great one for Sarah.

Sarah Gheuens

Analyst

Yes. Thank you. You're right. Not all patients experience VOCs. Our intent is to deliver a product that can treat all aspects of sickle cell disease, so hemolytic anemia and sickle cell pain crises. We do as a principle across our different programs, we believe based on the mechanism of action of our drug, the drug can work across the whole spectrum of disease. A range of hemoglobin levels and a range of sickle cell pain crises. Now, from a clinical trial perspective, if you want to be able to measure a treatment effect, you need to enroll a patient population that has enough of the event ongoing to be able to measure that reduction. That is why our clinical trial from an endpoint perspective has the inclusion criteria of sickle cell pain crisis two or more. But I mean, just to be able to measure that treatment effect, but our expectation is that, it can work for no matter how many sickle cell pain crises you have, including just one or zero. Unfortunately, that patient population can't enroll into the trial, because we would not be able to measure a treatment effect in that patient population over the course of a year. Again, the drug is meant to address all aspects of sickle cell disease and our intent would therefore be based on the data we have generated across the program, including in all of our clinical trials to go for, a label that can treat sickle cell disease after a regulatory review.

Brian Goff

Analyst

To that point, Sarah, maybe you want to comment too on Fatigue, which we try really hard not to oversimplify these diseases, especially sickle cell disease is so complex and sickle cell pain crises, VOCs is one aspect, but Fatigue is another very profound need.

Sarah Gheuens

Analyst

I just mentioned the primary endpoints, right, the hemoglobin primary endpoint of hemoglobin and sickle cell pain crisis reduction of the other primary endpoints to be able to measure hemolytic anemia and VOC impact. As you know, that's like supported by a bunch of other secondary endpoints of which one is indeed focused on Fatigue because that's what we hear from patients and from physicians that Fatigue is a very, very, very impactful and burdensome to the patient population and as typical for all of our designs, we really try to incorporate patient feedback and therefore have incorporated Fatigue as a main secondary endpoint. We've just announced the thalassemia trial data Energize in which we did meet our key secondary endpoint for the first time on a patient reported outcome that measures Fatigue. We are very hopeful for the RISE UP study as well.

Operator

Operator

One moment for our next question. And our next question comes from Gregory Renza from RBC Capital Markets. Your line is now open.

Gregory Renza

Analyst

Great. Good morning, Brian and team. Congrats as always on the continued progress. Thanks for taking my questions. Maybe, Brian, I'll just start with, ACTIVATE-kids T perhaps for Sarah. Sarah, could you just help us understand maybe the statistical assumptions? Certainly, seems to us that that PYRUKYND effect is clinically meaningful, the results largely consistent with the adult studies. Was the study underpowered? Was there a placebo behavior that maybe was consistent or inconsistent with historical transfusion rates? Any added color you have would be great. And then I have a follow-up. Thank you.

Tsveta Milanova

Analyst

Sure. Thanks for the question. ACTIVATE-kids T, we really tried to design a study that is appropriate for an ultrarare disease population and therefore it shows to really leverage the adult data we have generated to get to a sample size that would be appropriate for this stage of development and provide us with adequate data. We have to use pretty complex statistical methodology to look at the primary endpoint of transfusion reduction. As mentioned, it's pretty complex because it depends on the amount of data you borrow from the adult study, and that gives them specific weights that you leverage to look at your pediatric data. We can't say that, across the board, we see a treatment effect. That's why we were very specific in the press release around our low or moderate weight borrowing of the adult study data because the data, while we see positive odds ratios, the confidence intervals around that do include one. That's why we are very mindful of that. To your point, the data that we have observed, the fact that there are six patients, who became transfusion free, remember this is a regularly transfused patient population, meaning, they have a lot of transfusions coming into the trial. Now, these patients become transfusion free. That is a clear demonstration of a treatment effect in that specific patient population. If you're one of those six kids, that is a very meaningful difference for that specific person and their family, because this has also obviously an impact to the family. That's why we are very excited about the results actually, because we do feel like there is a meaningful story to be told out of this study. The main goal, of course, of this study, which we also can't -- which we are very happy about is the safety assessment. This is our first pediatric clinical trial after completing an adult program and get to an indication statement there. This is our first endeavor to really expand the age range of that patient population. From that perspective, we do feel the safety data is very important. The efficacy data that we have generated is very encouraging. And so, we're very excited about the next steps in the development.

Gregory Renza

Analyst

That's helpful. Thank you. And just one other question, just on thalassemia. It's helpful to have sort of walk through some of the messaging as well as some of the characteristics that doctors could value. Just wondering if you had any thoughts on maybe real-world usage patterns assume all goes as planned and the approval comes through. When it comes to the patients maybe staying on the drug longer-term, any expectations or thoughts on patients perhaps with less hemoglobin improvement benefit, but maybe more meaningful quality of life improvements or staying on the drug? And if you have any thoughts on what level of hemoglobin improvement we would anticipate for that patients to stay on the drug longer-term? Thanks again, Brian and team.

Brian Goff

Analyst

There's a lot in there, Greg. Maybe we'll just focus on the crux of your question that I heard was focused on the unmet need. I think Tsveta could certainly put some color on that, because we just returned from -- she noted in her prepared comments the Cooley's Anemia Foundation meeting, which is the annual meeting for thalassemia patients in the U.S. It's a pretty inspiring venue to be in and certainly brings home the range of unmet need that exists. Keeping in mind these are the engaged patients. These are the ones that are actually skewed towards transfusion dependency and attend meetings like that. But Tsveta has a lot of insights that we're continuing to build upon.

Tsveta Milanova

Analyst

Absolutely. I'll start and then maybe I can also transfer to Sarah to talk a little bit kind of the broad applicability of our mechanism of action to across the hemolytic anemia being thalassemia. Absolutely, Brian and I had the opportunity to attend the Cooley's Anemia Foundation Patient and Family Conference. It was truly, truly inspiring to have the opportunity to connect with many patients and treating physicians as well, listen and learn about the patient journeys and the stories there, and very importantly get the excitement and the enthusiasm of both the patient and the clinical community, about potential new innovative therapies coming to the thalassemia space, including the potential of mitapivat as an approved product for that indication in the U.S. Of course, this is the most engaged and educated audience and it was great to get their feedback. Greg, as you mentioned, we've heard it very clearly from -- the physician community and the market research that they'll consider all of the relevant endpoints that we measure in our clinical trials, as patients' characteristics when making a treatment decision being hemoglobin level, being transfusion burden, being iron overload and of course fatigue. Sarah talked about the importance of fatigue both in thalassemia and sickle cell disease. As a commercial preparation, we are actually looking to reach a lot broader audience both from the physician and patient space and we are actively educating on the disease, the importance of actually improving hemoglobin levels and hemolysis, given that hemolysis is truly linked to developing disease complications and leads to increased morbidity and mortality in that patient population. You asked a little bit about kind of the initial patient segments that probably we'll focus on at launch and how we can expand that over time. When you think about the feedback that we got from the clinicians on the patient's characteristics, they'll look to prescribe and when you think about, which are the patients that are more likely to have regular visits and interactions with the healthcare system, this will be the transfusion-dependent patients, given that they are regularly going and seeing their clinicians when they're being transfused as well as patients, who are more symptomatic either have comorbidities linked to the disease as well as lower hemoglobin levels and fatigue, we would expect these patients probably to hear and be considered for makeup -- in the initial stages of the launch. As we look to educate product clinical and patient community, we'll look to expand that into a broader patient population. Now I'll hand it over to Sarah to talk about the importance of mitapivat’s mechanism of action in treating the totality of thalassemia.

Sarah Gheuens

Analyst

Thanks, Tsveta. I would like to come back to the hemoglobin cutoffs in the clinical trials. As you know, we have the clinical trial endpoint of 1 gram per this leader or more that we look at. But to your point, Grace, there are patients who may not reach that bar of becoming a responder in the clinical trial, but still may experience some benefit that we have seen in our PKD patient population. We also see that in the thalassemia patient population. We highlighted at Dr. Tahir showed a waterfall plot showing how the hemoglobin distribution in the patient population exposed to mitapivat versus exposed to placebo looks like and you could see a very similar figure in the thalassemia patient population, as what we have shown before in the pyruvate kinase deficiency patient population. There is definitely people who are improving some of their hemoglobin values, but they not reach that clinical trial endpoint, which is also one of the reasons why to set up points, the hemolysis component is important, how patients feel is important. This is why we allow patients and physicians to decide at the end of a clinical trial to still roll over in the open label extension even if they don't meet the clinical trial bar.

Operator

Operator

One moment for our next question. Our next question comes from Divya Rao from TD Cowen. Your line is now open.

Divya Rao

Analyst

Hi, guys. Congrats on the quarter. I had a question on the ACTIVATE-kids T. Looking at the AEs in the trial, could you comment on if there are any changes in sex hormone levels, in the mitapivat arm versus the placebo? And then I have a follow-up.

Tsveta Milanova

Analyst

Thanks for the question. We have not gone into deeper detail yet on all of the safety beyond what we've actually put out in our press release. We look forward to do that at an upcoming medical meeting.

Divya Rao

Analyst

Okay. That's helpful. And then, on AG-946, I was curious when we could expect to see the Phase 2A data. And if it would be at a medical meeting.

Brian Goff

Analyst

First Divya, we have to practice saying mitapivat because that's ivat. We're going to try to do the same because 946 is burned into our heads, but Sarah, you're going to comment on that.

Sarah Gheuens

Analyst

The numbers are still burning in my head as well, so apologies if I switch. But yes, as mentioned, our current milestone and focus is the Phase 2b. The team is very, very focused on that. We will declare later when we present the 2a data at an appropriate time, but it will be at an upcoming medical meeting.

Brian Goff

Analyst

And I just want to reemphasize real quick that, again for MDS, and we'll learn as we proceed through the clinical trial program here, but this is a very compelling market for us. We certainly took note of the Revlisol recently reported sales data that shows now a run rate in excess of $1.6 billion annualized. There is very high unmet need in this population. Certainly, as is the case in all the diseases we pursue, there's room for multiple mechanisms of action. If we're successful, this would be not only novel PK activation, but in a pill form, which would be very significant for patients.

Operator

Operator

Our next question comes from Salveen Richter from Goldman Sachs. Your line is now open.

Unidentified Analyst

Analyst

Hi. This is Lydia on for Salveen. Thanks so much for taking our question. Just another on thalassemia. Ahead of the full Phase 3 ENERGIZE-T data that's coming at a medical meeting later this year. Could you just frame expectations for the data in terms of any additional insights or data points that we could expect to glean from it in terms of the clinical meaningfulness? Thanks so much.

Tsveta Milanova

Analyst

Yes. In our press release, we highlighted the primary details around the primary endpoints and one of the secondary endpoints from transfusion independence. So, we will have that again because we are very happy with that. As mentioned we also met all three settings very end points and we will be presenting the data on that as well. And then, of and we will be presenting the data on data as well, and then of course safety as well. It's going to be a typical intent to treat analysis presentation in line with how we designed and ran the clinical trial and have done the pre-specified analyses. We're very pleased with the results, in the key secondary endpoints. You may see that we actually have a very long interval in which we measure transfusion reduction for the first time. And so, we are of course again very happy with the results that that trial generated. The two trials have now completed and have their data read out. We are very eager to move forward in the development and the regulatory engagement and are looking forward to really have the review started.

Operator

Operator

Thank you. One moment for our next question. And our next question comes from Tessa Romero from JPMorgan. Your line is now open.

Tessa Romero

Analyst

Hi. Good morning, Brian and team. Thanks for taking our question. On the regulatory side in the U.S. for thalassemia, how should we think about the gating factors at this point for your submission of the sNDA? Is the base case here a standard or priority review? And then, our second question is just a follow-up on the arrangement with NewBridge. How should we think about the soonest we could start to see revenues here? And how many patients have thalassemia, specifically in the Saudi region? Thanks.

Brian Goff

Analyst

Sarah, you want to start with regulatory pathway?

Sarah Gheuens

Analyst

Yes. Again, we're very eager to work together with the SBA and submit the package for their review and assessment. We're doing a typical process really. We don't comment on when or how. Those are milestones for later. I think we're just pleased with the progress our team is making and are just very excited to get everything going.

Brian Goff

Analyst

And then, Tsveta, NewBridge, anything?

Tsveta Milanova

Analyst

The same thing with GCC. As we've mentioned, we're super excited about having signed agreement with NewBridge to take on the next steps of preparing for submission and potential commercialization given that GCC is the second most important region for us after the U.S. When it comes to submissions and approval timelines, we'll start working with NewBridge. We haven't provided the specific timelines on that. There are about 70,000 patients with thalassemia in the region. As we start working with the NewBridge to deepen our market understanding, we might be able to provide more information, but not in this stage.

Brian Goff

Analyst

Clearly, Saudi Arabia is the largest component of that. That part is very clear. And do you want to just make one comment on access pathways in the region?

Tsveta Milanova

Analyst

Absolutely. When we think about the GCC region, the best way to think about it is probably closer to the European kind of ways assessing pricing and reimbursement submission, getting to a pricing and reimbursement agreement and uptake. The process starts with the submission at the regulatory level where you actually obtain a price at the national level. And then depending on the market, there are numerous steps out there that you actually get formulary approval and agreements with the health institutions, other local hospitals and other private markets, and over time we are expected to see tenders in the different markets and we look forward to working with NewBridge to navigate all of these key steps to patient access and speed the process as quickly as we can.

Brian Goff

Analyst

We're excited about that arrangement, but just to come back to by far our number one priority is the U.S. Again, we're thrilled to have the opportunity and Tsveta is working very assertively with the commercial team to build out our commercial prowess in rare diseases, building on the momentum, we've had in PKD and moving into thalassemia and hopefully beyond sickle cell as well.

Operator

Operator

Thank you. One moment for our next question. Our next question comes from Alec Stranahan from Bank of America. Your line is now open.

Alec Stranahan

Analyst

Thanks for taking our questions. Just a couple from us. First, one follow-up on the sNDA submission and just sort of framing the data that will be going into that. Is the full data we should expect by the end of this year, kind of the complete picture of what the FDA will be reviewing, and anything incremental on efficacy from that update, or more just sort of expanding on the safety and the secondaries? And then, one question on the PK study in the non-transfusion setting next year. Any read throughs to be made from the data today to that study? Obviously, different primary endpoints and different patient population? Thanks.

Brian Goff

Analyst

Sure. Thanks, Alex. We'll take those in sequence. Sarah, maybe the first one you can just comment on our planned package of data. Secondly, we'll talk about pediatrics.

Sarah Gheuens

Analyst

Of course, now the program as mentioned the two randomized clinical trials have completed, have been locked and we have the data. We're very excited to put that together. We are really doing the standard type of work that we would normally be doing for a submission that follows standard cuts, timelines and updates that we need to do and are very eager to work with the regulators and get that process started. There is always questions back and forth. There, I mean, we're just going to go through the motion. In regards to the ACTIVATE-kids T endpoint, we are very pleased with the data that was generated in this clinical trial, both from a safety and efficacy.

Brian Goff

Analyst

Yes. And then, thoughts on the link or the read through as it would be called to ACTIVATE-kids non-transfusion dependent patients?

Sarah Gheuens

Analyst

Again, it's a similar methodology applied for ACTIVATE-kids non-regularly transfused patient population and we're blinded. We are very eager to get to the next point and then we'll get that data package. We, in the ACTIVATE-kids T trial, we are very pleased because the transfusion free response truly highlights that the mechanism of action of mitapivat is applicable to kids as well. And so, now we're hoping that that also translates into the other trial.

Alec Stranahan

Analyst

Thank you.

Operator

Operator

I'm showing no further questions. I would now like to turn the call back over to Brian Goff, CEO Agios, for closing remarks.

Brian Goff

Analyst

Thanks, Justin. Thanks a lot everybody for the great questions and for participating in today's call. This is clearly a very exciting time at Agios. Just thinking of the year so far to date, it's been a little bit breathless in the best way possible with continued delivery on our milestones and maybe more importantly a lot still to come that we're very much looking forward to. We have strong conviction that we're poised to deliver transformative new therapies for patients and ultimately to also create significant long-term value to shareholders. Thanks again and we look forward to speaking with you again soon.

Operator

Operator

This concludes today's conference call. Thank you for participating. You may now disconnect.